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PD3 > PVS > Flashcards

PVS Flashcards

1
Q

Pulsus parvus? Condition?

A

Small/weak

Decrease cardiac output

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2
Q

Pulsus parvus et tardus? Condition?

A

Weak and delayed pulse

Aortic stenosis

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3
Q

Bounding pulse? Condition?

A
  • Increased pulse pressure
  • Rapid, brief peak

↑ stroke volume:
Aortic regurgitation, bradycardia, AV fistulas

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4
Q

Pulsus alternans?

A

Variation in pulse amplitude occurring with alternate beats due to changing systolic pressure

Left ventricular failure

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5
Q

Pulsus bigeminus?

A

Two beats occur in rapid succession, followed by a pause (normal beat alternating with a premature contraction)

Premature ventricular contractions

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6
Q

Bisferiens pulse?

A

Two palpable peaks

Hypertrophic obstructive cardiomyopathy

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7
Q

Pulsus paradoxus?

Conditions?

A

A drop in systolic pressure > 10 mm Hg on inspiration

COPD exacerbations, acute cardiac tamponade, constrictive pericarditis, obstructive sleep apnea

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8
Q

ALLEN TEST

A
  • when suspecting arterial insufficiency in the arm or hand

- to ensure patency of the ulnar artery before puncturing the radial artery for blood samples

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9
Q

Drains the superficial portions of the lower abdomen and buttocks, the external genitalia

A

Horizontal group

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10
Q

Drains the corresponding area for the great saphenous vein

A

Vertical group

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11
Q

risk factors for PAD (7)

A 
Risk Factors:  
smoking
hypertension
hyperlipidemia
family history
renal disease
diabetes
hyperhomocysteinemia
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12
Q

Ask the patient to sit up with legs dangling down. Compare both feet, noting the time required for:
Return of pinkness to the skin (<10 sec)
Filling of the veins of the feet and ankles (15 sec)

  1. Look for any unusual rubor (dusky redness) to replace the pallor.
A

Postural Changes Test

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13
Q

Best initial (or screening) test for PAD

A

ABI index

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14
Q

Best initial imaging test

A

Duplex Doppler ultrasound

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15
Q

Acute Limb Ischemia

A

Ischemia: deficient arterial blood supply due to occlusion

Causes: sudden embolism or thrombosis (most common)
graft/ angioplasty occlusion
Trauma

Pre-existing CAD/PAD (+ previous history of claudication)

Clinical finding: of pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia

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16
Q

Chronic Arterial Insufficiency

A

Pain: Intermittent claudication –> rest pain
Color: Pallor on elevation; dusky red on dependency
Skin changes: Thin, shiny, atrophic skin; hair loss; thickened & ridged nails
Ulceration: If present, involves toes or points of trauma on feet
Pulses: Decreased or absent
Temperature: Cool
ABI < 0.9

17
Q

> 1.40

A

non-compressible

18
Q

1.00-1.40

A

normal

19
Q

.91-.99

A

borderline

20
Q
A

abnormal

21
Q

Aortoiliac Occlusive Disease (AIOD) AKA Leriche Syndrome

A

HISTORY & PE
Claudication of calf muscles, then thigh, hip and buttocks
Impotence/ erectile dysfunction
Diminished/ absent femoral, popliteal and pedal pulses bilaterally

Imaging
Same as for PAD

22
Q

HX
• Asymptomatic (most)
• Sx of compression, erosion: chest pain, dyspnea, cough, hoarseness, dysphagia
• Sx of aortic regurgitation

PE
•Unremarkable
•AR murmur
•Marfan features

A

Unruptured THORACIC AORTIC ANEURYSM

23
Q

HX
Acute, ripping chest pain radiating to the back
Dyspnea

PE
Hypotension, tachycardia
Acute AR murmur
Shock

A

Dissecting/ ruptured THORACIC AORTIC ANEURYSM

24
Q

Abdominal ultrasound is for ?

A

Screening!

Indications
F: age 65- 75y who have ever smoked
M: age 65–75 y who have smoked at least 100 cigarettes in their lifetime
(+) FHx of AAA

25
Q

CT or MRI with contrast ?

A

to determine the location and size of abdominal aortic aneurysms

26
Q

M: F is 3:1
Young (<40 year old)
Smoking is the strongest risk factor

A

Thromboangiitis Obliterans

27
Q

Thromboangiitis Obliterans DX ?

A

Arteriogram (smooth tapering lesions in distal vessels; corkscrew collaterals)

28
Q

Usually women <30
Symmetric episodic attacks
No tissue injury
Negative ESR, ANA, C3 & C4

A

Primary Raynaud’s phenomenon

29
Q 
Age > 40, M>F
Systemic symptoms
Asymmetric attacks
Tissue injury or digital ulcers -uncommon
Abnormal nailfold capillaroscopy*
A

Secondary Raynaud’s phenomenon

30
Q

Cold stimulation test is used in ?

A

Raynaud ‘s Phenomenon

31
Q

Compression of the popliteal artery by the gastrocnemius or popliteus muscle
Young, athletic men and women (M>F), usually <30 yo
A congenital (3%) or acquired condition
Hx: Intermittent, exercise-induced, unilateral claudication
PE: Normal; may have diminished pulse on ankle dorsi/plantarflexion

A

Popliteal Artery Entrapment Syndrome

32
Q 
50% are bilateral
Associated with aneurysm of the aorta
SSx
pulsatile mass
limb ischemia secondary to thrombosis or embolism
A

Popliteal artery aneurysm

33
Q

DDx to Popliteal artery aneurysm?

A

Baker’s cyst

Non-pulsatile mass
Knee pain, stiffness, swelling
Aggravated by prolonged standing, not relieved by rest

34
Q

Venous Disease risk factors ? (4)

A

Female gender
Obesity
Pregnancy
Virchow’s triad
Hypercoagulability: malignancy, pregnancy, use of estrogen
Endothelial injury : trauma, surgery
Venous stasis: immobility (long trips, bed rest)

35
Q

Chronic venous insufficiency s/s:

A

Hyperpigmentation
Stasis dermatitis
Ulcers (medial malleolus)

36
Q 
SSx: 
Leg pain 
Aching, burning
provoked by standing, relieved by elevation
dilated tortuous bluish-green veins
A

Varicose Veins

37
Q

Thrombosis and inflammation, usually of the great saphenous vein
Epidemiology: F > M
Location: LE > US; sites of trauma (IV catheters)
Risk factors: Virchow’s triad

SSx
leg pain
\+ fever
erythema, tenderness, induration (“nodular cord”) along the course of a vein 
swelling
A

Superficial Thrombophlebitis

38
Q

Imaging: Duplex ultrasound
Findings: lack of compressibility of vein; impaired blood flow

A

Superficial Thrombophlebitis

PD3 (11 decks)

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